| Entity Name: | JAY E. OLSSON, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 07 Nov 2003 (21 years ago) |
| Document Number: | P03000128699 |
| FEI/EIN Number | 32-0100081 |
| Address: | 401 N. WICKHAM RD., SUITE S, MELBOURNE, FL 32935 |
| Mail Address: | 401 N. WICKHAM RD., SUITE S, MELBOURNE, FL 32935 |
| ZIP code: | 32935 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAY E. OLSSON, D.O., P.A. 401(K) PROFIT SHARING PLAN | 2022 | 320100081 | 2023-07-25 | JAY E. OLSSON, D.O., P.A. | 14 | |||||||||||||||||||||||
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| JAY E. OLSSON, D.O., P.A. 401(K) PROFIT SHARING PLAN | 2021 | 320100081 | 2022-09-14 | JAY E. OLSSON, D.O., P.A. | 14 | |||||||||||||||||||||||
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| JAY E. OLSSON, D.O., P.A. 401(K) PROFIT SHARING PLAN | 2020 | 320100081 | 2021-03-15 | JAY E. OLSSON, D.O., P.A. | 15 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2021-03-15 |
| Name of individual signing | JAY E. OLSSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-07-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3212429031 |
| Plan sponsor’s address | 401 N. WICKHAM ROAD, SUITE S, MELBOURNE, FL, 32935 |
Signature of
| Role | Plan administrator |
| Date | 2020-02-14 |
| Name of individual signing | JAY E. OLSSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| KANCILIA, JOHN RESQ. | Agent | 1795 WEST NASA BLVD., MELBOURNE, FL 32901 |
| Name | Role | Address |
|---|---|---|
| OLSSON, JAY E, Dr. | President | 401 N. WICKHAM RD., SUITE S, MELBOURNE, FL 32935 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2009-01-27 | 401 N. WICKHAM RD., SUITE S, MELBOURNE, FL 32935 | No data |
| CHANGE OF MAILING ADDRESS | 2009-01-27 | 401 N. WICKHAM RD., SUITE S, MELBOURNE, FL 32935 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-01-27 | 1795 WEST NASA BLVD., MELBOURNE, FL 32901 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-07-18 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-02-11 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-25 |
| ANNUAL REPORT | 2017-01-25 |
| ANNUAL REPORT | 2016-01-28 |
| ANNUAL REPORT | 2015-02-23 |
Date of last update: 30 Jan 2025
Sources: Florida Department of State
